Abstract

Organ-specific autoimmunity in type 1 diabetes mellitus: Screening with respect to glycemic control

Type 1 diabetes (T1D) is a tissue-specific autoimmune disease and often associated with other autoimmune diseases; so our study aimed to define the occurrence of thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) in autoimmune thyroid disease (AIT), tissue transglutaminase antibody (TTGAb) in celiac disease, And to evaluate the relationship between the presence of these antibodies and glycemic control. Our retrospective study included 60 Kuwaiti patients with T1D who attended and follow in Diabetes outpatient clinics of Kuwait primary health care centers during the period of 2014-2015. For them, recorded data for age, sex, duration of diabetes, Body Mass Index (BMI), HbA1c was reviewed. Patients were screened for the presence of Specific antibodies to islet antigens (ICAb), glutamic acid decarboxylase autoantibodies (GADAb), insulin autoantibodies (IAA), TPOAb, TGAb, TTGAb and also thyroid stimulating hormone (TSH) were measured by ELISA. Of the total 60 patients (20 men, 40women, mean age was17.95 ± (5.44) y; the mean duration of diabetes was 6.63 ± (4.27) y; mean HbA1c was 10.41± (1.96) %. Only 58 (96.7%) were positive for GADAb, 32 (53.3%) were positive for ICAb, and 48 (80%) were positive for IAA, 14 (23.3%) patients were positive for TPOAb, 11 (18.3%) were positive for TGAb, 10 (16.7 %) were positive for both TPOAb and TGAb; furthermore 8 (13.3%) patients were positive for TTGAb. Neither organ-specific autoimmune disease (AIT and celiac disease) nor pancreatic β cells autoantibodies had a significant association with the glycemic control. In our study, we confirmed the high prevalence of a second organ-specific autoimmune disease in individuals with type 1 diabetes. Also Subclinical forms of these disorders have no influence on diabetes control. Further research will be necessary to test these relationships in a prospective follow-up study.

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